Pharmacological properties

Diclofenac (sodium salt 2(2.6 — dikhlorfenilamino) - phenylacetic acid) belongs to group npvp. has the expressed anti-inflammatory and also moderate febrifugal activity. the mechanism of action is caused by inhibition of synthesis of prostaglandins. at course treatment of a pseudorheumatism, medicine intensively gets into a cavity of joints, reduces pain at rest and at the movement, promotes increase in volume of movements in the affected joints, reduces morning constraint and puffiness of joints. the lasting effect develops in 1–2 weeks of treatment.

At intake in intestines, its maximum concentration in blood plasma is reached in 1–2 h. Meal slows down absorption speed a little, however does not influence its level. About 99% of medicine contact proteins of blood plasma. Diclofenac well gets into fabrics and into synovial fluid where its concentration can exceed that in blood plasma. Plasma elimination half-life of blood makes 1–2 h, of synovial fluid — 3–6 h. Diclofenac is metabolized in a liver. About 65% of medicine are removed with urine in the form of metabolites, about 1% — in not changed look. About 35% of medicine are removed with a stake.

Indication

Osteoarthrosis, the pseudorheumatism ankylosing a spondylitis, other inflammatory diseases of joints and a backbone, soft tissues. the short course is appointed at a tendinitis, a bursitis, a postoperative pain syndrome, a dysmenorrhea.

Use

Inside in time or after a meal. in the first 3 days, diclofenac is appointed on 25–50 mg by 2–3 times a day, sometimes the daily dose is raised to 100–150 mg (in 4–6 receptions). duration of a course of treatment averages 40 days, the course dose of medicine — from 3 to 6 g to children is aged more senior than 6 years and to teenagers medicine appoint in a dose 0.5-2 mg/kg a day in 2–3 receptions. at treatment of a juvenile pseudorheumatism the increase in a dose to 3 mg/kg a day is admissible that corresponds to the maximum daily dose for children.

Contraindication

Round ulcer of a stomach and duodenum, a disease of a liver and kidneys, iii a trimester of pregnancy and the period of feeding by a breast, hypersensitivity to drug, oh, the urticaria, sharp rhinitis and other allergic reactions caused by reception npvp, age up to 6 years. do not appoint or apply only under control of the doctor at oh, hypersensitivity to npvp, the chronic or recurrent dispepsichesky phenomena, the instruction on a round ulcer in the anamnesis, abnormal liver functions and/or kidneys, ag, chronic heart failure, tendency to bleedings.

Side effects

Nausea, anorexia, pain in epigastric area, a meteorism, a lock, diarrhea. in some cases, especially at frequent and prolonged use of medicine, erosive cankers of a mucous membrane of a digestive tract with symptoms of gastrointestinal bleeding (melena) and also a headache, a depression, drowsiness, a hamaturia, a proteinuria, a nephrotic syndrome, opn are possible, it is very rare — thrombocytopenia, anemia (owing to occult bleedings from bodies of a digestive tract), allergic reactions (especially at patients with oh) — skin rash, an itch, an erythema, a bronchospasm.

Interaction

At a concomitant use diclofenac reduces effects of furosemide and hypotensive medicines, increases concentration of digoxin in blood plasma. the concomitant use with kaliysberegayushchy diuretics can lead to development of a hyperpotassemia. at co-administration with other npvp or gks the risk of development of gastrointestinal bleeding increases. it is undesirable to combine diclofenac with a methotrexate and cyclosporine.

Overdose

Is shown by a headache, psychomotor excitement, irritability, dizziness, spasms.

In sharp poisoning showed probe gastric lavage, intake of activated carbon, symptomatic treatment.

Storage conditions

B the dry, protected from light place.